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Siparsky PN, Bailey JR, Dale KM, et al. Open Reduction Internal Fixation of Isolated Chondral Fragments Without Osseous Attachment in the Knee: A Case Series. Orthop J Sports Med. 2017;5(3):2325967117696281doi: 10.1177/2325967117696281.
Siparsky, P. N., Bailey, J. R., Dale, K. M., Klement, M. R., & Taylor, D. C. (2017). Open Reduction Internal Fixation of Isolated Chondral Fragments Without Osseous Attachment in the Knee: A Case Series. Orthopaedic journal of sports medicine, 5(3), 2325967117696281. https://doi.org/10.1177/2325967117696281
Siparsky, Patrick N, et al. "Open Reduction Internal Fixation of Isolated Chondral Fragments Without Osseous Attachment in the Knee: A Case Series." Orthopaedic journal of sports medicine vol. 5,3 (2017): 2325967117696281. doi: https://doi.org/10.1177/2325967117696281
Siparsky PN, Bailey JR, Dale KM, Klement MR, Taylor DC. Open Reduction Internal Fixation of Isolated Chondral Fragments Without Osseous Attachment in the Knee: A Case Series. Orthop J Sports Med. 2017 Mar 17;5(3):2325967117696281. doi: 10.1177/2325967117696281. eCollection 2017 Mar. PMID: 28451604; PMCID: PMC5400143.
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Orthop J Sports Med. 2017 Mar 17;5(3):2325967117696281. doi: 10.1177/2325967117696281. eCollection 2017 Mar.

Open Reduction Internal Fixation of Isolated Chondral Fragments Without Osseous Attachment in the Knee: A Case Series.

Orthopaedic journal of sports medicine

Patrick N Siparsky, James R Bailey, Kevin M Dale, Mitchell R Klement, Dean C Taylor

Affiliations

  1. Division of Sports Medicine, Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
  2. Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California, USA.
  3. Department of Orthopaedic Surgery, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
  4. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
  5. James R. Urbaniak, MD, Sports Sciences Institute, Durham, North Carolina, USA.

PMID: 28451604 PMCID: PMC5400143 DOI: 10.1177/2325967117696281

Abstract

BACKGROUND: Isolated chondral fractures of the knee are a rare and challenging problem, typically occurring with an acute traumatic event such as dislocation of the patella or ligamentous injury. Historically, repair of unstable chondral fragments without osseous attachment has not been recommended due to concerns about the limited healing potential of cartilage.

PURPOSE: To describe a technique for fixation of large isolated chondral fractures of the knee and present 3 cases where large chondral fragments without osseous attachment were fixed successfully with chondral darts and biologic adhesive.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: The senior author reviewed his case logs for all patients on whom he performed open reduction and internal fixation on large isolated cartilage fragments without osseous attachment. Three were extracted from his review. The clinical and radiographic outcomes were retrospectively reviewed.

RESULTS: Successful results and complete healing was obtained in all 3 patients. This procedure can be done in the setting of concurrent injury, such as anterior cruciate ligament tear, using single- or multistaged chondral repair and ligament reconstruction techniques.

CONCLUSION: Isolated chondral fragment repair techniques provide the orthopaedic surgeon an additional option for treating these challenging injuries. Primary fixation can be accomplished for what have been historically considered "unsalvageable" fragments.

Keywords: cartilage; chondral; chondral fracture; fixation

Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

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